PROJECT 4: CURRENT AND EMERGING TOBACCO PRODUCTS IN A RURAL CONTEXT: INFLUENCES OF PRODUCT CHARACTERISTICS ON PERCEPTIONS, BEHAVIORS, AND BIOLOGIC EXPOSURES

项目摘要/摘要 美国青少年的吸烟率有所下降，但年轻人中并没有出现类似的下降 无烟烟草(ST)的使用。在青少年和年轻人中，多用途的趋势也在不断增长 多种烟草产品的组合。近几十年来，ST的用法已从较老的用法转变为较年轻的用法 人口统计，与日益增长的行业营销和ST产品的多样性相一致 特点。这些新的ST产品包括不同类型、品牌、口味和不同级别的 生物可利用的尼古丁和致癌的亚硝胺。需要独立的数据来说明这些因素是如何 ST和新兴烟草产品的差异化特征有助于青年的认知、启蒙、 已确定的使用、多次使用，最终，随着时间的推移，接触尼古丁和致癌物质。这个项目将 通过三个具体目标消除这一研究差距：(1)确定ST和其他烟草产品的影响 农村青少年的特点，包括包装、风味特征和产品设计 当前和正在出现的无烟、可燃和替代产品的感知危害、可接受性和吸引力 烟草产品；(2)前瞻性地描述随时间推移的烟草使用行为(例如，开始、停止、 强度、产品转换和多用途的变化)以及家庭和社会因素以及特定产品 特征预测行为的转变；以及(3)评估使用特定烟草产品的影响 关于农村青少年接触尼古丁和烟草特有亚硝胺的产品类型，包括使用 潜在的新产品。这项研究将包括1500名以学校为基础的青少年前瞻性队列 在24个月的时间里，跟踪调查了5次。青少年的定性研究 他们的父母/监护人将嵌套在队列中，以更深入地了解 产品特征和社会背景因素会影响人们对以下问题的看法和行为决策 烟草产品。收集的生物标志物将揭示尼古丁和亚硝胺的暴露如何随 使用模式的差异和产品的差异。这个项目将提高对如何不同于 ST和新兴烟草产品的特征对行为和健康影响的测量 对尼古丁和亚硝胺的感知、行为和暴露。这个项目将产生证据 与现有和新出现的烟草产品和意愿的潜在监管和公共宣传有关 贡献行为和健康结果数据，用于影响的经济模型。这样的证据将 向FDA通报ST和其他烟草产品的特性，以减少青少年的萌芽 并告知FDA针对农村人口的传播战略。

PROJECT SUMMARY/ABSTRACT Cigarette smoking among U.S. adolescents has declined, but similar declines have not occurred in youth smokeless tobacco (ST) use. There is also a growing trend among adolescents and young adults of poly-use of multiple tobacco products in combination. In recent decades, ST use has shifted from an older to a younger demographic, coincident with increasing industry marketing and expanding diversity in ST product characteristics. These new ST products include different types, brands, flavors, and varying levels of bioavailable nicotine and cancer-causing nitrosamines. There is a need for independent data on how these differentiating characteristics of ST and emerging tobacco products contribute to youth perceptions, initiation, established use, poly-use, and ultimately, exposure to nicotine and carcinogens over time. This project will address this research gap via three specific aims: (1) Identify the impact of ST and other tobacco product characteristics, including packaging, characterizing flavors, and product design, on rural adolescents' perceived harm, acceptability, and appeal of current and emerging smokeless, combustible, and alternative tobacco products to; (2) Prospectively characterize tobacco use behaviors over time (e.g., initiation, cessation, changes in intensity, product switching, and poly-use) and how family and social factors and specific product characteristics predict transitions in behavior; and (3) Evaluate the impact of use of specific tobacco products and product types on rural adolescents' exposure to nicotine and tobacco-specific nitrosamines, including use of potential new products. This study will include a school-based prospective cohort of 1500 adolescents attending rural high schools, followed for 5 survey waves over 24 months. Qualitative studies with adolescents and their parents/guardians will be nested in the cohort to provide greater depth of understanding of how product characteristics and socio-contextual factors influence perceptions and behavioral decisions regarding tobacco products. Collected biomarkers will reveal how exposure to nicotine and nitrosamines varies with differences in use patterns and difference in products. This project will improve understanding of how different characteristics of ST and emerging tobacco products impact behavior and health effects by measuring perceptions, behaviors, and exposure to nicotine and nitrosamines. This project will generate evidence relevant to potential regulation of and public communication on current and emerging tobacco products and will contribute behavioral and health outcome data for use in economic models of impact. Such evidence will inform FDA regulation of the characteristics of ST and other tobacco products so as to reduce youth initiation and inform FDA communication strategies for rural populations.